France, longtime leader in universal health coverage


Nearly one billion people do not have access to basic health services and nearly 100 million people every year are plunged into extreme poverty when paying for the care they need.

In Africa and Southeast Asia, nearly one third of households have to borrow money or sell their property to pay for healthcare.

France has made Universal Health Coverage (UHC) a focus of its 2017-2021 Global Health Strategy.

Universal Health Coverage: Definition

Access for all, including vulnerable and marginalized populations, to quality health services without risk of financial difficulties.

Impacts well beyond the areas of health and well-being

Establishing Universal Health Coverage is an investment whose benefits go well beyond the areas of health and well-being (SDG 3). It also generates inclusive and sustainable economic growth (SDG 8), better education results of children, adolescents and young people (SDG 4), greater productivity of workers and improved nutrition of the population (SDG 2).

A French priority

France promotes a new approach to universal health coverage. It is considered a cross-cutting objective. National health systems need to be improved comprehensively if UHC is to be achieved.

Since 2012, France has advocated at the highest level for UHC in international organizations and bodies. Thanks to these efforts, UHC was chosen in September 2015 as a target in goals of the 2030 Agenda for Sustainable Development.

P4H Network

In 2007, France and Germany co-founded the Providing for Health (P4H) Network. Joined by multilateral agencies and bilateral partners such as Spain, Switzerland, USAID and the Asian Development Bank, this network aims to coordinate international joint efforts at national, regional and global level to establish fair and effective health social protection systems in the direction of UHC.

France also encourages various health funds, including the Global Fund to Fight AIDS, Tuberculosis and Malaria and GAVI, the Vaccine Alliance, to take action to strengthen national health systems.

France assists countries directly in defining and implementing UHC policies through its bilateral development assistance managed by the Agence Française de Développement (French Development Agency, AFD) and Expertise France, which are both agencies of the Ministry for Europe and Foreign Affairs. They have made UHC a priority for their action.

In 2018, AFD invested €385 million in the promotion of UHC by strengthening health systems and the affordability of care, through loans (sovereign and non-sovereign) and donations included in European Union fund transfers.

On 20 June 2018, the AFD and Expertise France were managing 13 national (Benin, Comoros, Mali, Morocco, Mauritania, Niger, Senegal, Chad) and regional (WAEMU area, CIMA area, sub-Saharan Africa) projects to support UHC.

Focus on the Solidary and Health Initiative for the Sahel

This €30-million initiative financed by the Ministry for Europe and Foreign Affairs, managed by the AFD since 2013, aims to promote access to healthcare for children under five in four countries of the Sahel (Mali, Niger, Senegal and Chad) via support for mutually supportive mechanisms for exemption from payment promoted by States and/or non-governmental organizations.

Updated: April 2019